HHS Amendment Excludes DACA Non-US Citizens From PCIP Coverage

Non-US citizens under age 31 who have resided in the US and have been granted temporary relief under the Department of Homeland Security's June 15 Deferred Action for Childhood Arrivals (DACA) process will not be eligible for Pre-Existing Condition Insurance Plan (PCIP) coverage pending their removal determination.

Last week, the Department of Health and Human Services (HHS) released a clarifying amendment to the interim final rule on the PCIP program. This amendment, effective immediately, revises the definition of "lawfully present" that was codified in the interim final regulation on PCIPs (published July 30, 2010) to exclude this group from PCIP participation.

The Affordable Care Act (ACA) prohibits non-grandfathered health insurance coverage issuers from denying health care coverage or inflating health insurance rates based on preexisting conditions. This section of the ACA takes effect in 2014, at which time coverage will be made available through the Affordable Health Insurance Exchanges. In the interim, ACA directs states or nonprofit entities to establish temporary high-risk health insurance pool programs to cover eligible US citizens with preexisting conditions.